An alternative analgesic agent for intra-articular corticosteroid injections (IAI) in juvenile idiopathic arthritis (JIA) – a fentanyl lollipop

Background Intra articular injections are an effective and widely used technique that involes the direct application of a corticosteroid compound such as triamcinalone hexacetonide into a joint with active synovitis. Local IAIs can avoid many of the unwanted adverse effects of sytemic steroids but in children younger than 11 years or those with a polyarticular presentation a general anaesthetic is typically required. Traditional local anaesthetic agents include topical agents such as lignocaine or gaseous agents such as entonox (nitrous oxide). We have introduced an unique form of analgesia for this procedure since the establishment of our national unit in 2006 in form of fentanyl lollipops (Actiq).